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General NPI Number Information
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NPI Number | 1013869247
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Entity Type | Organization
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Legal Business Name | TIDEWATER ANESTHESIA CONSULTANTS PLLC
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Dates
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Enumeration Date | 02/11/2026
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 2750 GODWIN BLVD
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City | SUFFOLK
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State | VA
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Zip | 23434-8036
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Country | US
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Telephone | 757-983-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 460 WILLIS RD
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City | MADISON
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State | VA
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Zip | 22727-2657
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Country | US
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Telephone | 786-208-8366
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | JAMES S OLEKSA
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Credential | MD
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Telephone | 786-208-8366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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